PHOTO

NOTE: PLEASE READ THE INSTRUCTIONS CONTAINED IN THE PROSPECTUS/WEBSITE CAREFULLY BEFORE FILLING THIS

SPORTS AUTHORITY OF INDIA Netaji Subhas National Institute of Sports: Patiala

Academic Session 2019-20 APPLICATION FORM

Application for admission to (Please tick whichever is applicable)

1. Diploma in Sports Coaching: at Patiala at Bangalore

at Kolkata at Thiruvananthapuram

2. M.Sc. (Sports Coaching): at SAI NSNIS, Patiala

Last date for submission of application: 4th June 2019

Game/Sport: …………………………..…………… (Write the name of game/sport intended for

the course)

1. Name of the Candidate : …………………………………………………………………

2. Male/Female : ……………………………………………………………………

3. Date and place of birth : ……………………………………………………………………

4. Father’s/Guardian’s/Husband’s name: ……………………………………………………

5. Mother’s Name: ………………………………………………………………………………

6. State of Domicile: ……………………………………………………………………………

7. Married/Unmarried: …………………………………………………………………………

8. Category (GEN/ST/SC/OBC) : ……………………………………………………………

9. Whether Employed/Unemployed : ………………………………………………………

10. Permanent address with pin code: …………………………………………………………

……………………………………………………………………

11. Present postal address with pin code: ……………………………………………………

………………………………………………………………

12. Landline/Mobile Number & e-mail ID:………………………………………………………

13. SBI Collect Number with date :………………………………………………………………

14. Educational Qualification from Matriculation onwards:

Sr.No. Examination Passed Board/University Year of Passing %age

15. Sports Achievements:

Name of the Competitions Name of the State/ University/Unit

represented

Year & Venue of the Championship/Meet

Position 1

st / 2

nd / 3

rd /

Participation

International (Senior): -Olympic Games -World Championship -Asian Games /Championship -Commonwealth Games/Championship -Major Recognized International Competitions

National: -Senior National Championship -Youth National Championship -Junior National Championship

Inter-University: -All India Inter-University

Departmental Meets: -All India Police Games -Inter-Services Competition -Inter Railway Championship

North-East: -North-East Games

DECLARATION BY THE CANDIDATE

I hereby solemnly affirm that: (i) the statement made and information furnished by me in the

application form is true/correct and all the photo copies of my certificates enclosed are legitimate; (ii) that

if any information furnished therein is fraudulent, incorrect or untrue, in material particular, I understand

that the selection and admission to the course is liable to be cancelled at any stage; (iii) that I will not

join/participate any other course/competition or appear in any other examination and also will not marry

during the diploma course 2019-20; (iv) that before filling this admission form, I have read all the

instructions quoted in Prospectus/Website carefully and agree to abide by the rules and regulations of

Sports Authority of India.

Place:…………………………… Dated:…………………………..

Signature of the Candidate

NO OBJECTION CERTIFICATE BY THE EMPLOYER

The under-mentioned employee of this Department/Unit is recommended to appear in entrance test

and interview for admission to one year Diploma in Sports Coaching. If he/she is selected, this

Department/Org/Unit has no objection for his/her pursuing diploma course at any Academic Centre of SAI

as per this application filled by the candidate and documents enclosed.

Name of the employee: ………………………………………………….. Designation:

…………………………………......

Gross salary per month: ……………………………….. Department/Unit (full

address):…..………………………………

…………………………………………………………………………………………………………………………

……………

PinCode:………………………. ContactNo.:………………………Fax No.:…………………………………..

Place:…………………………… Dated:…………………………..

Signature of the Competent Authority (With Name, Designation & Seal)

(For Employed Candidates only: Employed candidates are advised to get this NOC from their employers)

SPONSORED/RECOMMENDED BY THE STATES/SPORTS DEPARTMENTS

Recommended the following sportsperson for admission to one year Diploma in Sports

Coaching by this State/Sports Department as to the suitability of the candidate (Full address of

the State/Department):

………………………………………………………………………………………………………………

………….……………………………………………………………………………………………………

Name of the Candidate: ………..…………………………….. State/Department:

….………………………..…

If selected, he/she will be awarded the following from this State/Sports Department: (please

tick on appropriate box):

Stipend/Scholarship: Yes No Boarding & Kit Expenses: Yes No

Place:……………………………

Dated:…………………………..

Signature of the Competent Authority (With Name, Designation & Seal)

(For candidates those are sponsored or recommended by the States/Sports

Departments)

GENERAL INSTRUCTIONS

1. The application form completed in all respects should be accompanied with SBI Collect

Receipt print out of Rs.1000/- as administrative charges (non-refundable) for all the centers (as

mentioned in prospectus/website).

2. Copies of the certificates mentioned therein along with copy of matriculation certificate

showing age proof must be attached with the application form. Candidate can send self-attested

photo copies of their certificates. Incomplete application will not be considered.

3. Fix one stamp size latest photograph on the form and bring two stamp size photographs at

the time of interview.

4. Original certificates are to be produced at the time of reporting for registration. Candidates

shall not be permitted to attend admission tests/interview, if the required certificates and marks

sheets are not provided.

5. Call letters will be sent to each eligible candidate for admission tests/interview. The list of

eligible candidates will also be uploaded at our website well in time. If any candidate did not

receive call letter due to some postal reason and his/her name is available in the list of eligible

candidates at our website, such candidates are advised to report for admission test/interview at

the concerned centre. In case of insufficient space in any of the columns of application, to give

additional information, separate sheet may be used.

6. Final selection will be based on the tests (theory & practical) /Interview conducted at the

centre concerned. The admission will summarily be cancelled at any stage during the course, if

any discrepancy regarding eligibility and medical fitness comes to the notice even after the

commencement or towards completion of the course. The Institute will not bear any liability in

such cases. SAI reserves the right to change the venue of the course of candidate due to

administrative reasons.

7. The diploma course is of ten months duration (July to April) plus two months mandatory

internship at any SAI Regional Centres/Sub Centres in India.

8. None of the trainee will be allowed to participate in the State/National level or any competition

during diploma course.

AFFIDAVIT BY PARENT/GUARDIAN

I _______________________________________________father/mother/guardian of

_______________________________________________ who is seeking admission in Diploma in

Sports Coaching at any Academic Center of Sports Authority of India have carefully read and fully

understood the provisions contained in the regulations concerning ragging.

I understand and fully aware as to what constitutes ragging

I understand and fully aware of the penal and administrative action that is liable to be taken against my

son/daughter/ward in case he/she found guilty of or abetting ragging actively or passively or being part of

a conspiracy to promote ragging.

I hereby solemnly undertake that:

a) My son/daughter/ward will not indulge in any behavior or act that may be constituted as ragging

b) My son/daughter/ward will not participate in or abet or propagate through any act of commission

or omission that may be constitute as ragging under the regulations

I hereby affirm that if my son/daughter/ward found guilty of ragging, he/she is liable for punishment according to Regulations without prejudice to any other criminal action that may be be taken against him/her under any panel law or any law for the time being in force. I hereby declare that my son/daughter/ward have not been expelled or debarred from admission in any institution in the country on account of being found guilty or abetting or being part of a conspiracy to promote ragging and further affirm that in case the declaration is found to be untrue the admission of my son/daughter/ward is liable to be cancelled. Declare this_______________________day of __________month of___________year.

Signature of Deponent

Name____________________________

Address_____________________________

Telephone/Mobile No.____________________

VERIFICATION

Verified that the contents of this affidavit are true to the best of my knowledge and no part of the

affidavit is false and nothing has been concealed or misstate therein.

Verified this_______________________day of __________month of___________year.

Signature of Deponent

Solemnly affirmed and signed in my presence on this the___________________day of ______

month of___________year after reading the contents of this affidavit.

OATH COMMISSIONER

Hkkjrh; [ksy izkf/kdj.k

usrkth lqHkk’k jk’Vªh; [ksy laLFkku] ifV;kykA

‚kS{kf.kd l= 2019&20

izos‛k ds fy, vkosnu&i= ¼d`Ik;k tks ykxw gks ml ij fVd djs½

1- [ksy izf‛k{k.k esa fMIyksek dkslZ % ifV;kyk &&& csaxywj &&&

dksydkrk &&& fr#ouUriqje

2- ,e-,l-lh ¼LiksVlZ dksafpax½ % Hkk[ksizk uslqjkdzhla] ifV;kyk &&

vkosnu i= tek djus dh vafre frfFk % 04 जून] 2019

fVIi.kh % d`Ik;k bl QkeZ dks Hkjus ls igys foojf.kdk@csolkbV esa tkjh vuqns‛kksa dks lko/kkuhiwoZd i< +sA

¼Li’V v{kjksa esa fy[ksa ½

[ksy@dwn &&&&&&&&&&&&&&&&&&&& ¼ikB~;Øe ds fy, fufnZ’V [ksydwn dk uke fy[ksa½

1- vkosnd dk uke &&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&

2- iq#’k@efgyk &&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&

3- rkjh[k vkSj tUe LFky &&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&

4- firk@laj{kd@ifr dk uke &&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&

5- ekrk dk uke &&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&

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10- fiu dksM ds lkFk LFkk;h irk &&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&

&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&

11- fiu dksM ds lkFk orZeku irk &&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&

&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&

12- nwjHkk’k@eksckbZy u- o bZesy vkbzZMh &&&&&&&&&&&&&&&&&&&&&&&&&&&&&&

13- rkjh[k lfgr ,lchvkb dyDV ua- &&&&&&&&&&&&&&&&&&&&&&&&&&&&&&

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14 eSfVªd ls vkxs dh ‚kS{kf.kd vgZrk %

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i=ksa dh lHkh QksVks izfr;ka oS| gSaA

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ikB~;dze esa p;u vkSj izos‛k ds fdlh voLFkk dks jn~n dj fn;k tk;sxkA

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2019&20 ds ikB~;dze esa ‚kknh ugha d:axkA

¼4½ bl izos‛k QkeZZ ds Hkjus ls igys eSaus foojf.kdk@csolkbV esa mfYyf[kr lHkh vuqns‛kksa

dks lko/kkuhiwoZd i<+ fy;k gS vkSj Hkkjrh; [ksy izkf/kdj.k dh fofu;eksa dk ikyu djus ds

fy, lger gwaaA

vH;FkhZ ds gLrk{kj

LFkku

fnukad

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vkosnu i= ij fopkj ugha fd;k tk,xk A

ekrk&firk@laj{kd }kjk ‚kiFk i=

1- Jh@Jherh@lqJh----------------------------------------------------------------------------------- ekrk&firk@laj{kd -----------------------------------------------------

------dks --------------------------------------------------¼laaLFkku dk uke½ eas izos‛k ns fn;k x;k gS A lEcfU/kr jSfxax ds fofu;eksa esa

tkjh izko/kkuksa dks lko/kkuhiwoZd i<+ vkSj iwjh rjg le> fy;k gSA

2- jSfxax ds lafo/kku D;k gS] dks eSaus iwjh rjg tku o le> fy;k gSA

3- eSaus n.M vkSj iz‛kklfud dkjZokbZ dks iwjh rjg le> vkSj tku fy;k gS fd fdlh ekeys esa esjk iq=@iq=h

lfdz; :Ik ls vFkok fuf’dz; :Ik ls nks’kh ik, tkus vFkok jSfxax dks mdlkus] jSfxax dks c<+kok nsus ds ‘kM~;U=

ds :Ik esa nks’kh ik;k tkrk gS rks mlds fo:) mfpr dkjZokbZ dh tk,A

4- eSa fu’BkiwoZd ‚kiFk ysrk gwa

d- esjk iq=@iq=h jSfxax ls lEcfU/kr fdlh dk;Z o O;ogkj esa ‚kkfey ugha gksxkA

[k- esjk iq=@iq=h fofu;eksa ds v/khu jSfxax ds rkSj ij xfBr fdlh dk;Z vFkok =qfV ds tfj,

mdlkus vFkok izpkj djus esa Hkkx ugha ysxkA

5- eSa ;gka n`<+rkiwoZd dgrk gwa fd esjk iq=@iq=h jSfxax esa nks’kh ik;k tkrk gks rks fdlh vU; vijk/kh dkjZokbZ ds

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v/khu dqN le; ds fy, mlds fo:) dkjZokbZ dh tk,A

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esa fyIr ik, tkus dh fLFkfr esa mls ns‛k ds fdlh Hkh laLFkku esa izos‛k ls ckgj ;k fu’dkflr dj fn;k tk,

vkSj eSa ;g Hkh fu‛p;iwoZd dgrk gwa fd ?kks’k.kk i= esa dqN vlR; ik, tkus dh fLFkfr esa esjs iq=@iq=h ds

izos‛k dks jn~n dj fn;k tk,A

;g --------------------- o’kZ ------------------------ ekg--------------------- fnu dks ?kksf’kr fd;k x;kA

vf/k‛kk{kh ds gLrk{kj

uke ---------------------------------------------

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nwjHkk’k@eks-u- ---------------------------------------

lR;kiu

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dqN Hkh vlR; ugha gS vkSj u gh blesa fNik;k vFkok v;FkkFkZ fooj.k gSA

;g --------------- o’kZ ------------------- ekg------------------ fnu dks ?kksf’kr fd;k x;kA

vf/k‛kk{kh ds gLrk{kj

eSaus ‚kiFk i= dh fo’k;&oLrq i<+us ds Ik‛pkr---------------- o’kZ -------------- ekg ---------fnu dks esjh mifLFkfr esa vkSipkfjd :Ik ls

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[ksy dkasfpax esa 1 o’khZ; fMIyksek ds izos‛k ds fy, [ksy ijh{kk o lk{kkRdkj ds fy,

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fMIyksek ikB~;Øe djus ds fy, dksbZ vkifÙk ugha gSA

fu;ksDrk dk uke ---------------------------------------------------------------------inuke ------------------------------------------dqy

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---------------------------------------------------------------------------------------------------------------------------------------

fiu dksM --------------------------------- lEidZ ua----------------------------------------QSDl ua---------------------------------

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¼uke] inuke o lhy lfgr½

LFkku ----------------------

fnukad -----------------------

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fu;ksDrk ls bl vukifÙk izek.k i= dks izkIr djsaA

----------------------------------------------------------------------------------------------------------------------------------------------------------------

jkT;ksa@[ksy foHkkxksa }kjk izk;ksftr@flQkfj‛k

mi;qZDRk vH;FkhZ ds fy, jkT;@[ksy foHkkx }kjk [ksy dksfpax esa ,d o’khZ; fMIyksek

ds izos‛k ds fy, fuEu f[kykM+h dh flQkfj‛k dh tkrh gS ¼ jkT;@foHkkx dk iwjk irk½% ----

---------------------------------------------------------------------------------------------------------------------------------

vH;FkhZ dk uke -------------------------------------------------------------jkT;@foHkkx ---------------------------------------

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fd;k tk;sxkA

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5- izos‛k ijh{kk@lk{kkRdkj ds fy, izR;sd ik= mEehnokj dks cqykok i= Hkstk tk,xkaA

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tk,xk ;fn fdlh vH;FkhZ dks cqykok i= dqN iksLVy dkj.kksa ls izkIr ugha gksrk rks

muds uke gekjs csolkbV ik= vH;fFkZ;ksa dh lwph esa gS rks ,sls vH;fFkZ;ksa dks

lEcfU/kr dsUnz ij izos‛k ijh{kk@lk{kkRdkj ds fy, fjiksVZ djus ds fy, lykg nh

tkrh gSA vfrfjDr lwpuk nsus ds fy, vkosnu ds fdlh dkWye esa i;kZIr LFkku u

gksus ds dkj.k vyx ‚khV dk iz;ksx fd;k tk ldrk gS A

6- vafre p;u lEcfU/kr dsUnz ij ijh{kk ¼F;wjh ,oa izSDVhdy½ ds vk/kkj ij gksxkA

ikB~;dze d s vkjEHk gksus vFkok iwjk gksus ds Ik‛pkr~ ik=rk vkSj fpfdRlk LokF;rrk

ds lEca/k esa folaxfr dksbZ ikbZ tkrh gsS rks fcuk fdlh uksfVl ds ikB~;dze ds

nkSjku fdlh voLFkk ij izos‛k jn~n dj fn;k tk,xkA laLFkku ,sls ekeyksa esa fdlh

mÙkjnkf;Ro dks ogu ugha djsxkA Hkkjrh; [ksy izkf/kdj.k iz‛kklfud dkj.kksa ls

vH;FkhZ ds ikB~;dze ds LFkku esa ifjorZu dk vf/kdkj j[krk gS A

7- fMIyksek ikB~;dze 10 ekg dh vof/k ¼tqykbZ ls vizSy½ rFkk Hkkjr esa fdlh Hkk[ksizk

ds {ks=h; dsUnz@midsUnzksa ij nks ekg dk vfuok;Z baVuZf‛ki djuk gksxkA

8- fMIyksek ikB~;dze ds nkSjku jkT;@jk’Vªh; Lrj vFkok fdlh izfr;ksfxrk esa fdlh

izf‛k{kkFkhZ dks lgHkkfxrk dh vuqefr ugha gksxhA

SPORTS AUTHORITY OF INDIA

NETAJI SUBHAS NATIONAL INSTITUTE OF SPORTS : PATIALA

Dr.S.S. Roy D.K. Rathore Dr.I.P.Nagi Executive Director (Academics) Incharge Academics Deputy Director

Tele .Fax: 0175-2211539 E-mail: academics.nispatiala @gmail.com.

Admission to One Year ‘Diploma in Sports Coaching’ (Academic Session 2019-20)

We are glad to inform you that SAI is conducting one year ‘Diploma in Sports Coaching’ for the academic

session 2019-20 starting from 1st July 2019 at its all academic centres i.e. Patiala, Bangalore, Kolkata and

Thiruvananthapuram. Candidates desirous for admission to the Diploma in Sports Coaching for the session 2019-20

may fill the form after following the guidelines as per the required eligibility criteria.

I. SAI NSNIS, Patiala:

1.Athletics, 2.Basketball, 3.Boxing, 4.Cycling, 5.Cricket 6.Fencing, 7.Football, 8.Gymnastics, 9.Handball,

10.Hockey,11.Judo, 12.Table Tennis, 13.Swimming, 14.Volleyball, 15.Weightlifting, 16.Wrestling, 17.Wushu

18.Yoga

II. SAI NSSC, Bangalore:

1. Athletics, 2.Badminton, 3.Hockey, 4.Kabaddi, 5.Kho-Kho, 6.Softball, 7.Swimming, 8.Taekwondo,

9.Lawn-Tennis, 10.Volleyball.

III. SAI NSEC, Kolkata:

1.Archery 2. Athletics 3.Boxing 4.Cricket 5.Football 6. Gymnastics

IV. SAI LNCPE, Thiruvananthapuram:

1. Rowing, Kayaking & Canoeing

ELIGIBILITY CRITERIA

(Candidates seeking admission in Diploma in Sports Coaching should fulfill any category given below)

CATEGORY-A(i)

Educational Qualifications: Graduation

Sports Achievements: 1.Participation in major international recognized competitions. Or

2.Participation in the recognized senior national championships. Or

3.Two times participation in All India University/Recognized Junior/Youth National Championships/Inter-services meet/All India Police Games/Inter Railways Championships.

OR

CATEGORY-A(ii)

Educational Qualification Sports Achievement

Master in Physical Education One time participation in All India Inter-University Championship

Four years Bachelor’s of Physical Education/Post Graduate Diploma in Physical Education

Two times participation in All India University Championships.

CATEGORY-B (FOR INTERNATIONAL SPORTSPERSONS)

Educational Qualifications: 10+2

Sports Achievements: Participation in Olympic Games/Senior World Championship/Commonwealth Games/Asian Games/Senior Asian Championship.

CATEGORY-C (FOR NORTH-EAST CANDIDATES)

Educational Qualifications: Graduation

Sports Achievements: 1.Medal winner in North-East Games Or

2.Two times participation in North-East Games Or

3.Two times participation in All India University/Recognized National Youth Championship.

FEE STRUCTURE Sr.No. Fee Bifurcation(to be deposited at the time of

admission from Sr.No.1 to 14) Unemployed Candidates Employed Candidates Foreign Candidates

(To be deposited once at the time of admission)

(Figure in Rupees)

1 Examination Fee 2000.00 2000.00 2000.00

2 Scientific Journal 300.00 300.00 300.00

3 Insurance Fee 350.00 350.00 350.00

4 Library Fee 350.00 350.00 350.00

5 TV & Entertainment Fee 500.00 500.00 500.00

6 Medical Assistance for Minor Ailments 500.00 500.00 500.00

7 Syllabus 300.00 300.00 300.00

8 Security Deposit (Refundable) 2,000.00 2,000.00 2,000.00

9 Uniform (Blazer, Track-suit & Tie) 2,750.00 2,750.00 2,750.00

10 Establishment/Academic Charges 1,500.00 3,500.00 7,000.00

11 Lodging Charges 7500.00 14,000.00 26,000.00

12 Tuition Fee 5,000.00 15,000.00 25,000.00

13 Equipment Charges 1,000.00 1,000.00 1,000.00

14 Guest Faculty/Intramurals/Pedagogy, etc 1,000.00 1,000.00 1,000.00

Total 24,750-00 43,250-00 68,750-00

(To be deposited in three installments)0

15 Rs.250/- per day per candidate (250x30=6750 per month) Total: 7500x10=7,5000 Ist quarter-(July to September 2019) IInd quarter-(October to December 2019) IIIrd quarter-(January to April 2020)

7,5000-00 7,5000.00 7,5000.00

Age Limit: 23 to 35 years as on 1st July of the year of admission. Relax able up to three years in upper age for international players

i.e. Asian Games, Commonwealth Games, Olympic Games, World Championship and SC/ST/OBC candidates.

Course Duration: 12 Months: 1st July to 30

th April (10 months period of the course) and two months compulsory Internship from

May to June.

INSTRUCTIONS:

1. For detailed information kindly refer the prospectus

2. Last date for receipt of applications at the concerned centre is 4th

June, 2019.

3. Application fee: Application form can be downloaded from our website. If a candidate applies on downloaded application form,

he/she must deposit Rs.1000/- as administrative charges (non-refundable) in the prescribed proforma and enclose on line payment

receipt of Rs.1000/- generated through SBI Collect. Candidate may use different mode of payment while using SB Collect such as

Debit Card, Credit Card, Internet Banking, SBI Bank Challan and SBI Buddy application.

Path for SBI Collect is as:

1. https:wwwoninesbi.com

2. click on SB collect in the middle of the top blue bar

3. select new version click check box for payment proceed

4. State of Institute

5. Type of Institute select Education Institution Go

6. Select the Education Institute select Sports Authority of India – submit

7. Select payment category and proceed Application fee

8. Fill the form and submit

4. List of Eligible candidates inviting for admission tests/interview will be uploaded on our website by last Week of June 2019. Call

letters will also be sent to each eligible candidate for admission tests/interview. If any candidate did not receive call letter due to

some postal reason and his/her name is available in the list of eligible candidates on our website, such candidates are advised to

report for admission test/interview also.

5. Final selection will be based on the Written Examinations of General Knowledge, Written Examination in Specialized

Sport, Practical Examinations of specialized sport , physical fitness ability tests and Interview conducted by a board at the

centre concerned.

Dr.I.P.Nagi

Deputy Director